Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey.

OBJECTIVE

We aimed to study the characteristics on admission, diagnosis, treatment, and follow-up of hyperprolactinemic cases in a large multicenter study.

METHODS

We reviewed 233 hyperprolactinemic patients under 18 years of age who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia, and idiopathic hyperprolactinemia. Complaints of the patients and their treatment (medication and/or surgery) responses were evaluated in detail.

RESULTS

The mean age of the patients with hyperprolactinemia was 14.5 years, and 88.4% were female. In terms of etiology, microadenomas were observed in 32.6%, macroadenomas in 27%, idiopathic hyperprolactinemia in 22.7%, and drug-induced hyperprolactinemia in 6.4%. Common complaints in females (n = 206) were sorted into menstrual irregularities, headaches, galactorrhea, primary or secondary amenorrhea, and weight gain, whereas a headache, gynecomastia, short stature, and blurred vision were common in males (n = 27). Median prolactin levels were 93.15 ng/ml, 241.8 ng/ml, 74.5 ng/ml, 93.2 ng/ml, and 69 ng/ml for microadenomas, macroadenomas, idiopathic hyperprolactinemia, drug-induced hyperprolactinemia, and other causes of hyperprolactinemia, respectively. Of 172 patients with hyperprolactinemia, 77.3% was treated with cabergoline and 13.4% with bromocriptine. 20.1% of the patients with pituitary adenomas underwent pituitary surgery.

CONCLUSIONS

We present the largest cohort of children and adolescents with hyperprolactinemia in the literature thus far. Hyperprolactinemia is more common in females, and cabergoline is highly effective and practical to use in adolescents due to its biweekly dosing. Surgery indication should be revised in childhood.